Natsis Konstantinos, Didagelos Matthaios, Gkiouliava Anna, Lazaridis Nikolaos, Vyzas Vasilios, Piagkou Maria
Department of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P.O. Box: 300, 54124, Thessaloniki, Greece.
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
Surg Radiol Anat. 2017 May;39(5):559-565. doi: 10.1007/s00276-016-1796-5. Epub 2016 Dec 20.
Taking into consideration that the aberrant right subclavian artery (ARSA) is the commonest congenital aortic arch anomaly (prevalence 0.16-4.4%), our goal was to investigate its incidence in Greeks, with respect to location, course, and relationship to trachea and esophagus. Gender dimorphism, coexisting neural, and vascular variations were also examined. The clinical impact and embryological background of the variation are discussed.
Two hundred and sixty-seven (126 male and 141 female) formalin-embalmed Greek cadavers (mean age 59 ± 13 years) were examined.
The ARSA was detected in 6 cadavers (2.2%), 4 females (2.8%) and 2 males (1.6%). The artery followed a retroesophageal course in 83%, an interesophageotracheal course in 16.7%, while no pretracheal ARSA was detected. The ARSA coexisted with a bicarotid trunk, a Kommerell diverticulum, and a combination of them in one cadaver. Α combination of the ARSA with a thyroidea ima artery and a bilateral abnormal origin of the internal mammary artery was also detected in one case (17%), while no other associated anomaly was detected in a single case (17%). All ARSAs were accompanied with a right non-recurrent laryngeal nerve.
The ARSA has a relative high incidence in Greeks and a female predominance. The aberrant vessel follows a retroesophageal course in most cases and only one case with a location between trachea and esophagus was detected. The retroesophageal ARSA justifies the wide variety of clinical manifestations and complications occurred.
考虑到迷走右锁骨下动脉（ARSA）是最常见的先天性主动脉弓异常（患病率为0.16 - 4.4%），我们的目标是调查其在希腊人群中的发生率，包括其位置、走行以及与气管和食管的关系。还研究了性别差异、并存的神经和血管变异情况。并讨论了该变异的临床影响和胚胎学背景。
检查了267具（126例男性和141例女性）用福尔马林保存的希腊尸体（平均年龄59±13岁）。
在6具尸体（2.2%）中检测到ARSA；4例为女性（2.8%），2例为男性（1.6%）。该动脉83%走行于食管后方，16.7%走行于食管与气管之间，未检测到走行于气管前方的ARSA。在1具尸体中，ARSA与双颈动脉干、Kommerell憩室以及它们的组合并存。在1例（17%）中还检测到ARSA与甲状腺下动脉以及双侧胸廓内动脉异常起源的组合，而在1例（17%）中未检测到其他相关异常。所有ARSA均伴有右侧非返喉神经。
ARSA在希腊人群中发病率相对较高，且女性占优势。大多数情况下，异常血管走行于食管后方，仅检测到1例位于气管和食管之间。走行于食管后方的ARSA解释了其出现的多种临床表现和并发症。
